Organization
NIMOS LIGHT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ENOCH ASANTE RPH (OWNER)
(571) 224-7103
Entity
Organization
Contact information
Practice address
1940 RICHMOND AVE, WOODBRIDGE, VA 22191-2446
(571) 516-0890
Mailing address
1940 RICHMOND AVE, WOODBRIDGE, VA 22191-2446
(571) 516-0890
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
—
—
Other
Enumeration date
03/18/2026
Last updated
03/18/2026
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